Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $585.71 / $1,516.48 / $14,464.32	Facility		$585.71	$1,516.48	$14,464.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $312.19 / $577.54 / $1,104.25	Professional		$312.19	$577.54	$1,104.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $311.58 / $555.79 / $1,176.18	Professional		$311.58	$555.79	$1,176.18
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $350.25 / $1,740.33 / $3,404.60	Facility		$350.25	$1,740.33	$3,404.60
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $446.64 / $1,176.07 / $4,767.04	Professional		$446.64	$1,176.07	$4,767.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $421.10 / $731.00 / $777.59	Facility		$421.10	$731.00	$777.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $417.28 / $786.78 / $1,708.75	Professional		$417.28	$786.78	$1,708.75
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $452.49 / $765.15 / $1,463.69	Facility		$452.49	$765.15	$1,463.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $469.50 / $805.19 / $1,536.36	Professional		$469.50	$805.19	$1,536.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $177.76 / $996.20 / $1,756.29	Professional		$177.76	$996.20	$1,756.29
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $709.93 / $1,176.52 / $1,287.74	Facility		$709.93	$1,176.52	$1,287.74
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $236.51 / $845.75 / $878.35	Facility		$236.51	$845.75	$878.35
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $446.64 / $878.35 / $1,590.32	Professional		$446.64	$878.35	$1,590.32
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,154.13 / $1,778.80 / $3,404.60	Facility		$1,154.13	$1,778.80	$3,404.60
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $429.20 / $817.50 / $1,485.97	Professional		$429.20	$817.50	$1,485.97
United Facility/Professional Facility Modifier Low / Median / High Price $140.00 / $588.00 / $5,793.00	Facility		$140.00	$588.00	$5,793.00
United Facility/Professional Professional Modifier Low / Median / High Price $750.01 / $936.89 / $1,842.18	Professional		$750.01	$936.89	$1,842.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $336.85 / $336.85 / $719.24	Professional		$336.85	$336.85	$719.24